CPT 0495T
Contractor-priced
0495T · PFS Q4 2025 · Historical
No national PFS rate in Q4 2025
Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
Check for a published amount in your locality.
Not at a published national rate. CPT 0495T carries status C (carrier-priced) in the Q4 2025 release. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Treat the blank amount as unpriced, not as $0.
PFS status evidence
Inspect PFS status evidence
- Code
- 0495T
- Release
- Q4 2025, revision 1
- Result
- Contractor-priced
Citations
-
Establishes the PFS status (C) and the resulting pathway for this code: contractor-priced.
Physician relative value file (PPRRVU)Q4 2025 · revision 1
Latest revision of this release
Release period: October 1 – December 31, 2025
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
Record details
PPRRVU2025_Oct.csv in rvu25d-updated-09-11-2025.zip (row 440)- hcpcs (col 1)
- 0495T
- modifier (col 2)
- blank
- status_code (col 4)
- C
SHA-256: 8af460f38bf982b79b07269fbc8b7256a8ef3bd3aa025a9c5cb71c1e52523c56
Why is there no national PFS amount for 0495T?
Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Carrier-priced: no national payment amount.
Payment considerations Copy link
Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.
Other payment indicators (9)
Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply.
Global period: what 0495T's fee already covers Copy link
The global surgery concept does not apply to this code.
Can you bill it with another code? Copy link
Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit between it and 0495T.
Common payment questions Copy link
Why would a Medicare claim for 0495T be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- Its status indicator is C (carrier-priced)—Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. See status indicators
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
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Source & method
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Contractor amounts come from the MAC-published schedules and effective dates identified above. The PFS file establishes contractor pricing. Releases are immutable: historical evidence remains tied to the specified release. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
This citation identifies the source release, so its evidence remains reproducible after a newer release lands.
CPT 0495T National PFS baseline: No national PFS rate (Q4 2025; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/0495T/2025/D